Provider Account Manager – Strategic Accounts

Highmark Health

. Serve as primary relationship owner and executive liaison for strategically aligned provider groups within the Highmark Network .

Posted 9/18/2026full-timeWilkes-Barre • Pennsylvania • United StatesSeniorLeadWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing provider relationships and executing Value-Based Reimbursement initiatives, with a strong focus on improving health outcomes and operational efficiencies. Proficient in reimbursement methodologies, project management, and effective communication with diverse audiences.

Highest-signal resume keywords

Value-Based Reimbursement ManagementProvider Relationship ManagementProject ManagementPublic SpeakingHealthcare Industry Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Reimbursement MethodologiesFinancial ModelingAnalytical ModelingProcess ImprovementIssue Resolution

Soft Skills

Strong Written CommunicationStrong Oral CommunicationOrganizational Skills

Tools & Technologies

Microsoft PowerPointMicrosoft ExcelMicrosoft Word

Industry Keywords

HealthcareInsuranceCMS Laws and RegulationsMedicare AdvantageMedicaid PlansHIPAA Compliance

About the role

Key responsibilities & impact

Serve as primary relationship owner and executive liaison for strategically aligned provider groups within the Highmark Network
Manage and optimize assigned provider relationships across ancillary networks, independent physician organizations, and integrated delivery networks
Support and execute Value-Based Reimbursement performance improvement initiatives
Identify and drive Total Cost of Care reduction opportunities
Lead VBR activities, provider education, and implementation of new tools
Communicate with business leaders regarding VBR participation, opportunities, performance, and progress
Use resources, tools, analytics, and reports to improve health outcomes, lower unit costs, and increase patient satisfaction
Educate providers on medical expense management and HEDIS and STAR metrics
Lead provider relationships to prevent problems, improve operational efficiencies, and achieve corporate objectives
Educate providers on reimbursement policies, processing requirements, and technology offerings
Maintain communication with provider contacts through personal contacts, field visits, regional sessions, and professional organization meetings
Coordinate with contracting, operations, and support areas on initiatives, communications, and issue resolution
Triage provider issues and route communications to appropriate departments
Convey provider feedback to internal teams and represent the department on cross-functional teams and corporate initiatives
Maintain market, industry, and healthcare innovation knowledge
Perform other duties as assigned

Requirements

What you’ll need

7 years of experience in healthcare / insurance industry
3 years of experience presenting concepts to varying audiences
3 years of project management experience or other relevant experience with high accountability for managing multiple tasks with defined deadlines
Bachelor’s degree in Business, Healthcare related field, or relevant experience and/or education as determined by the company in lieu of bachelor's degree
In-depth understanding of the provider community, care delivery models, and the insurance industry
Knowledge of reimbursement methodologies and models, financial and analytical modeling
Public speaking skills
Process/quality improvement and issue resolution skills
Strong written and oral communication and organizational/project management skills
Working experience with Microsoft PowerPoint, Excel, and Word
Knowledge of CMS laws and regulations, Medicare Advantage and Medicaid plans, and HIPAA privacy and security regulations
Less than 25% travel
Must comply with applicable federal and state laws, company policies, HIPAA, privacy, information security, and code of business conduct requirements

Benefits

Comp & perks

Travel requirement: Less than 25%
Hybrid work arrangement
Occasional physical work site requirement
Employee access to company training requirements
Workplace accommodations available upon request